Hypoacusia and chronic renal dysfunction: new etiopathogenetic prospective

Area of Science:

• Nephrology
• Otolaryngology
• Microcirculation Biology

Background:

• The oto-renal axis links hearing loss (hypoacusia) and chronic kidney disease (CKD), but the cause of hearing impairment in CKD patients remains unclear.
• Hypoacusia in CKD is typically sensorineural, with cochlear damage being the primary site of injury.
• Inner ear and kidney share structural and functional similarities, particularly in microcirculation involving pericytes and podocytes.

Purpose of the Study:

• To summarize clinical findings on hypoacusia in nephropathy patients.
• To explore the etiopathogenic mechanisms of hearing loss in CKD by comparing inner ear and kidney microcirculation.
• To propose a model where inflammation contributes to oto-renal dysfunction.

Main Methods:

• Review and summarization of existing clinical studies on hearing loss in CKD patients.
• Comparative analysis of the structure and function of pericytes and podocytes in the inner ear and glomeruli.
• Development of a theoretical model for oto-renal dysfunction.

Main Results:

• Clinical studies confirm a high incidence of hypoacusia in patients with chronic renal failure.
• Pericytes (inner ear) and podocytes (kidney glomeruli) exhibit similar microcirculatory roles.
• Microcirculation defects, exacerbated by inflammation, are implicated in both inner ear and kidney dysfunction.

Conclusions:

• Inflammation is proposed as a key etiopathogenic mechanism for hypoacusia in CKD.
• Defective cross-talk between pericytes/podocytes and vascular endothelium initiates the degenerative process in the oto-renal axis.
• Understanding these shared mechanisms may lead to novel therapeutic strategies for oto-renal dysfunction.